Lice are small bugs that infect the scalp. Lice are an itchy nuisance. Fortunately, they very rarely cause serious injury or illness to a person. They can prove difficult to eliminate because they are resistant to treatment medication and often because of incomplete treatment. The treatment is a lot of work.
Lice live on the scalp and in the hair of people. They are passed by direct contact from head to head most frequently, but they can be passed on hands or shared combs or hats. Lice from dogs or other animals may find their way onto humans, but they will not live a long time on people.
Adult lice can be seen moving on hair close to the skin or scalp. They are about an eighth of an inch long. Eggs, called nits, are attached to the hair within an inch or so of the scalp. Eggs hatch in less than a week. The nits are egg shaped and can be removed only with firm effort. They don't brush off.
In Humboldt County, in the last five years, we have seen cases of lice that are not eliminated with a single application of medication. Several treatments and persistance are needed more now than a few years ago.
Treatment involves applying medication to kill the lice AND carefully combing AND picking out nits AND changing and washing things that touch the hair that might contain the lice. Everybody infected should be treated at the same time.
Over-the-counter medications work about as well as prescription medication. Lindane or Kwell are no longer on the market and should not be used. Any medication needs to be used correctly. FOLLOW DIRECTIONS CAREFULLY AND COMPLETELY. If you are using prescription Nix (permethrin) or RID or other over the counter medication containing pyrethrins, apply to dry hair or shampoo the hair first with SHAMPOO ONLY. Do not use any conditioner. Some authorities suggest leaving the medication on the hair for up to an hour. This is much longer than the label suggests, and it still may not work on the first application. Ovide (malathione) by prescription should be applied to DRY hair, rubbed in and allowed to dry naturally, and washed out after 12 hours with a shampoo without medication or conditioner. Nit pick (see below). The lice killing effect of medication will last for hours after it is rinsed. Most authorities suggest a second treatment a week later.
An unstudied but reported fairly effective non-drug treatment is applying mineral oil or real (fat) mayonnaise liberally to the hair and scalp and covering with a shower cap for eight to twelve hours. Wash the oil out with regular shampoo in the bath or shower. This can be repeated for several days. DO NOT USE KEROSENE OR GASOLINE.
Any of these treatments need to include careful combing and nit picking. It can take hours to do well. Use a fine toothed nit comb from the drug store or that comes with some medication. Or use a flea comb from the vet. Regular hair combs are not fine enough. Comb out the hair, and pick out any persistant nits, in sections on the scalp. Move to a new section and repeat. Use of a rinse of half vinegar and half water to loosen nits may make it easier to comb or pick them out.
Other treatments have been tried and can be discussed on the phone or in person.
Hats, towels, pillows, jackets, sheets, brushes, combs, or other items possibly infected with nits or lice can be disinfected by storing them in a plastic bag for two weeks (lice will die in that time), or washing in hot water and drying in a hot clothes dryer. Dry cleaning is effective, too. Stuffed chairs, the couch, or rugs where the child lies on the floor can be vacuumed and/or covered with a barrier fine cloth or heavy plastic sheet for two weeks. Sprays and insecticide "bombs" are not effective.
this information last updated 12/03